Lead Poisoning From a Toy Necklace

• Published in: Pediatrics (Evanston) Vol. 114; no. 4; pp. 1096 - 1099
• Main Authors: VanArsdale, Jessica L, Leiker, Richard D, Kohn, Mel, Merritt, T. Allen, Horowitz, B. Zane
• Format: Journal Article
• Language: English
• Published: Elk Grove Village, IL Am Acad Pediatrics 01-10-2004; American Academy of Pediatrics
• Subjects: Abdominal Pain - etiology; Anemia - etiology; Biological and medical sciences; Care and treatment; Case studies; Causes of; Chelation Therapy; Chemical and industrial products toxicology. Toxic occupational diseases; Child, Preschool; Children & youth; Consumer Product Safety; Diagnostic Errors; Foreign Bodies - complications; Foreign Bodies - diagnostic imaging; General aspects; Humans; Lead - blood; Lead poisoning; Lead Poisoning - diagnosis; Lead Poisoning - etiology; Lead Poisoning - therapy; Male; Medical sciences; Metals and various inorganic compounds; Miscellaneous; Pediatrics; Play and Playthings; Radiography; Stomach - diagnostic imaging; Toxicology; USA; Parental behavior; Pediatrics; lead poisoning; Behavior change; Lead; Foreign body; Poisoning; Saturnism; Heavy metal; Toy; lead foreign bodies
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2004-0361

A 4-year-old, previously healthy boy experienced intermittent abdominal pain for several weeks. He was diagnosed with probable gastroenteritis, but his symptoms worsened. Laboratory tests revealed normocytic anemia, and an abdominal radiograph showed a metallic foreign body in the stomach, without evidence of obstruction. Endoscopy resulted in the retrieval of a quarter and a medallion pendant from the stomach. A venous blood lead level measurement was extremely elevated, at 123 microg/dL (level of concern: > or =10 microg/dL). The medallion was tested by the state environmental quality laboratory and was found to contain 38.8% lead (388,000 mg/kg), 3.6% antimony, and 0.5% tin. Similar medallions purchased from toy vending machines were analyzed and were found to contain similarly high levels of lead. State health officials notified the US Consumer Product Safety Commission, which resulted in a national voluntary recall of >1.4 million metal toy necklaces.